4TM-10856-87421
3 vaccinations
4 coded responses
19 check-ins
4 free-text entries
0 call cases
- Sex
- Female
- Age at first dose
- 46-50
- ZIP prefix
- 602 / IL
- Registered
- 2021-04-03
- Relationship
- Self
- Race
- White
- Ethnicity
- Not Hispanic or Latino
Timeline
-
2021-03-26
Dose 1 — Moderna
-
2021-04-03
Registered in v-safe
-
2021-04-03
Survey response — day 7, dose 1MedDRA: Cyst, Fatigue, Feeling abnormal, Pain in extremity, Pruritus, Swelling — Feeling: Poor · Site: Pain, Redness, Swelling, Itching · Fatigue or tiredness, Diarrhea · Be unable to work, Be unable to do your normal daily activitiesFree text: Brain fog, strangest is that I got the shot 7 days ago. I didnt feel good Sunday 2 days after the shop. Then felt ok without soreness in the arm until this afternoon. Felt exhausted this afternoon, itchiness and swelling increasing, and I have what feels like a small cyst on my collar bone in the same side of my body that I got the shot.MedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-04-10
- 2021-04-16
-
2021-04-23
Dose 2 — Moderna
- 2021-04-23
-
2021-04-24
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Site: Pain · Fever · Headache, Muscle or body aches, Fatigue or tirednessAdult check-in
- 2021-04-26
- 2021-04-27
-
2021-04-29
Health check-in — days 1–6 daily, dose 2Feeling: Fair · Fatigue or tiredness · Be unable to workAdult check-in
- 2021-04-30
-
2021-05-07
Survey response — day 14, dose 2MedDRA: Oropharyngeal pain — Feeling: GoodFree text: Sore throatMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-05-14
- 2021-05-21
-
2021-05-29
Survey response — day 35, dose 2MedDRA: Fatigue, Headache — Feeling: Fair · Be unable to do your normal daily activitiesFree text: 1 day of headaches and deep fatigueMedDRA releases: 2021-09,2023-04,2024-11 · check-in free text available
- 2021-06-04
- 2021-07-23
- 2021-10-22
-
2021-12-11
Dose 3 — Moderna
-
2022-04-23
Survey response — 12 months, dose 2MedDRA: Diarrhoea, Headache, Influenza — Feeling: Fair · Be unable to work or attend school, Be unable to do your normal daily activitiesFree text: Headaches 12/2021; flu/diarrhea 1/2022MedDRA releases: 2024-11 · check-in free text available
- 2022-06-11
- 2022-12-11
Vaccinations
| Dose | Date | Manufacturer | Co-administered |
|---|---|---|---|
| 1 | 2021-03-26 | Moderna | |
| 2 | 2021-04-23 | Moderna | |
| 3 | 2021-12-11 | Moderna | No |
Free text
Release 6 — day 7, dose 1
Systemic reaction (other): Brain fog, strangest is that I got the shot 7 days ago. I didnt feel good Sunday 2 days after the shop. Then felt ok without soreness in the arm until this afternoon. Felt exhausted this afternoon, itchiness and swelling increasing, and I have what feels like a small cyst on my collar bone in the same side of my body that I got the shot.
Release 8 — day 14, dose 2
Symptoms: Sore throat
Release 8 — day 35, dose 2
Symptoms: 1 day of headaches and deep fatigue
Release 11 — 12 months, dose 2
Symptoms: Headaches 12/2021; flu/diarrhea 1/2022
Each entry is dated by the survey it was written in (the CDC re-sent the releases with survey dates in 2025); click a date to see that survey response. The CDC cut some text off at about 250 characters: symptoms in every release, and the other two fields in releases 9-12. Those entries are marked "cut off by CDC".
MedDRA terms by release
| Field | Preferred term | 2021-09 | 2023-04 | 2024-11 |
|---|---|---|---|---|
| SD | Diarrhoea | · | · | ✓ |
| SD | Fatigue | ✓ | ✓ | ✓ |
| SD | Headache | ✓ | ✓ | ✓ |
| SD | Influenza | · | · | ✓ |
| SD | Oropharyngeal pain | ✓ | ✓ | ✓ |
| SRO | Cyst | ✓ | ✓ | ✓ |
| SRO | Fatigue | ✓ | ✓ | ✓ |
| SRO | Feeling abnormal | ✓ | ✓ | ✓ |
| SRO | Pain in extremity | ✓ | ✓ | ✓ |
| SRO | Pruritus | ✓ | ✓ | ✓ |
| SRO | Swelling | ✓ | ✓ | ✓ |
✓ active code · ○ coded but marked inactive · blank = not in that release